A nurse is receiving information about four children during change-of-shift report. Which of the following children should the nurse assess first?
A 12-year-old child who has cystic fibrosis and reports difficulty clearing secretions
A 3-year-old child who has an atrial septal defect and a heart rate of 120/min
A 5-year-old child who has type 1 diabetes mellitus and a blood sugar of 150 mg/dL
A 2-year-old child who has diarrhea and reports abdominal pain
The Correct Answer is A
A. A child with cystic fibrosis and difficulty clearing secretions is the priority because airway clearance is critical in cystic fibrosis. Mucus buildup can lead to respiratory distress and infection, requiring immediate intervention.
B. A child with an atrial septal defect and a heart rate of 120/min is not the priority because a heart rate of 120/min is within the expected range for a 3-year-old and does not indicate immediate distress.
C. A child with type 1 diabetes and a blood sugar of 150 mg/dL is not the priority because this blood glucose level is slightly elevated but not critical.
D. A child with diarrhea and abdominal pain requires assessment, but dehydration or electrolyte imbalance develops over time. Airway issues take priority over gastrointestinal symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. "I can use chamomile tea to promote sleep." Chamomile has calming properties and is commonly used as a natural remedy to promote relaxation and improve sleep.
B. "Herbal medicines do not interact with conventional medications." Many herbs can interact with prescription medications, potentially causing harmful effects.
C. "I can use ginger to help treat headaches." Ginger is primarily used to reduce nausea and motion sickness rather than for headache relief.
D. "Herbal medicines are regulated by the Food and Drug Administration." Herbal supplements are not regulated by the FDA in the same way as prescription and over-the-counter medications.
Correct Answer is C
Explanation
A. "I will take the medication in the morning." Metformin extended-release can be taken once daily, but it is usually recommended with the evening meal to improve gastrointestinal tolerance.
B. "I will take the medication on an empty stomach." This is incorrect because metformin should be taken with food to reduce gastrointestinal side effects such as nausea and diarrhea.
C. "I will avoid crushing this medication." This is correct because extended-release tablets should not be crushed, split, or chewed, as this can alter the drug’s release mechanism.
D. "I will expect to gain weight." Metformin is not associated with weight gain; in fact, it may cause modest weight loss in some clients.
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